首发脑卒中患者照顾者家庭抗逆力干预方案的构建及应用

目的 构建首发脑卒中患者照顾者家庭抗逆力干预方案,并评价其应用效果。方法 通过文献研究、德尔菲专家函询及预试验构建首发脑卒中患者照顾者家庭抗逆力干预方案。将首发脑卒中患者照顾者按入院时间分为对照组41人和观察组40人;对照组实施常规护理,观察组在此基础上实施首发脑卒中患者照顾者家庭抗逆力干预方案。比较两组干预前、干预后1、3个月家庭抗逆力、脑卒中照顾者综合照顾能力及照顾者负担评分。结果 干预后,观察组照顾者家庭抗逆力、综合照顾能力评分显著高于对照组,照顾者负担评分显著低于对照组(均P<0.05)。结论 首发脑卒中患者照顾者家庭抗逆力干预方案能显著提高照顾者家庭抗逆力和综合照顾能力,降低照顾负担。     

家庭赋权干预对永久性肠造口患者照顾者的影响

目的 探讨家庭赋权干预应用于永久性肠造口患者主要照顾者的效果。 方法 选择永久性肠造口患者及主要照顾者97对作为研究对象,按照患者住院时间分为对照组48对和观察组49对。对照组患者给予常规护理,观察组在对照组基础上实施家庭赋权干预方案。比较两组照顾者干预前后照顾准备程度、照顾负担及心理一致感评分。 结果 干预后,观察组照顾者照顾准备度评分及心理一致感评分显著高于对照组,照顾负担评分显著低于对照组（均P＜0.05）。 结论 家庭赋权干预有利于提高永久性肠造口患者主要照顾者的准备度及心理一致感,对缓解照顾者照顾负担具有积极意义。     

阅读疗法对晚期肺癌患者照顾者心理状态的影响

目的 探讨阅读疗法对晚期肺癌患者照顾者获益感、照顾负担及负性情绪的影响.方法 将80例晚期肺癌患者照顾者按住院病区分为观察组和对照组各40人.对照组进行常规健康教育,干预组在对照组基础上实施阅读疗法.干预前、干预5周及干预9周分别采用照顾者获益感问卷、照顾者负担量表、焦虑自评量表及抑郁自评量表评估干预效果.结果 两组照...     

基于二元疾病管理理论的老年肺癌患者出院准备服务方案的实施

目的 探讨基于二元应对理论的老年肺癌患者出院准备服务方案的实施效果。方法 将肿瘤科收治的71例老年肺癌患者随机分为对照组35例和观察组36例。对照组给予常规护理,观察组实施基于二元疾病管理理论的出院准备服务方案。使用出院准备度量表、二元应对量表及癌症照顾者综合需求量表评价干预效果。结果 干预后观察组患者出院准备度、患者及其照顾者支持应对评分显著高于对照组,照顾者综合需求评分显著低于对照组（均P＜0.05）。结论 对老年肺癌患者及照顾者实施基于二元疾病管理理论的出院准备服务方案,有助于提高患者出院准备度及支持应对水平,满足照顾者综合需求。     

以家庭功能为导向的首发脑卒中患者照顾者支持干预方案实施

目的 评价以家庭功能为导向的首发脑卒中患者照顾者支持干预方案的实施效果。 方法 便利抽取103名首发脑卒中患者照顾者,按时间段分为对照组51名和干预组52名。对照组实施常规护理;干预组在此基础上实施以家庭功能为导向的照顾者支持干预方案,共3个月。比较两组照顾者做好家庭护理的准备、综合照顾能力及家庭功能得分。 结果 干预组出院时照顾者做好家庭护理的准备得分显著高于对照组（P＜0.05）;两组综合照顾能力总分及各维度得分、家庭功能得分比较,组间效应、时间效应和交互效应差异有统计学意义（均P＜0.05）。 结论 以家庭功能为导向的照顾者支持干预方案的实施可提高首发脑卒中照顾者家庭护理准备、综合照顾能力及改善患者家庭功能水平,可帮助患者更好地从医院过渡到家庭。     

积极自我表露干预对中青年脑卒中患者照顾者获益感的影响

目的 探讨积极自我表露干预对中青年脑卒中患者照顾者获益感、照顾负担及生活质量的影响。方法 将78名中青年脑卒中患者的照顾者按照病区分为对照组和干预组各39名。对照组接受常规护理，干预组在对照组的基础上实施为期4周、共8次的积极自我表露干预。比较两组干预前，干预后即刻，干预后1个月、3个月的获益感、照顾负担、生活质量情况。结果 干预组、对照组各有36名照顾者完成研究。干预后即刻及干预后1个月，干预组照顾者获益感评分显著高于对照组（均P＜0.05）；干预后即刻及1个月、3个月干预组照顾负担评分显著低于对照组，生活质量评分显著高于对照组（均P＜0.05）。结论 积极自我表露干预可有效地提高中青年脑卒中患者照顾者获益感，减轻照顾负担，提高生活质量。     

曼陀罗绘画疗法对癌症患者家庭照顾者益处发现的影响

目的 探讨曼陀罗绘画疗法对癌症患者家庭照顾者益处发现的影响。 方法 选取80例癌症患者家庭照顾者,分为观察组和对照组各40例,对照组行常规健康教育,观察组在对照组基础上实施8次曼陀罗绘画疗法。干预前后采用疾病获益感量表修订版评估干预效果。 结果 干预4周后,观察组益处发现总分显著高于对照组（P<0.05）。 结论 曼陀罗绘画疗法可提高癌症患者家庭照顾者益处发现水平,促进其身心健康。     

延续性护理对慢性心力衰竭患者家庭照顾者照顾负荷的影响

目的探讨延续性护理减轻慢性心力衰竭患者家庭照顾者照顾负荷的效果。方法将109名慢性心力衰竭患者家庭照顾者作为研究对象,实施为期6个月的延续性护理措施,比较干预前后家庭照顾者的负担水平。结果干预后照顾者个人负担、责任负担、负担总分显著低于干预前(均P0.01)。结论延续性护理可减轻慢性心力衰竭患者家庭照顾者的负担水平。     

以家庭为中心的赋权模式在PICC化疗患者中的应用

目的探究以家庭为中心的赋权模式对PICC化疗患者家庭照顾者照顾能力和照顾准备度的影响。方法将122例行PICC置管化疗的恶性肿瘤患者及其家庭照顾者随机分为对照组与赋权组各61例。对照组给予肿瘤科常规护理,赋权组实施以家庭为中心的赋权模式护理。结果干预后赋权组患者家庭照顾者照顾能力及照顾者准备度显著优于对照组(均P<0.01)。结论以家庭为中心的赋权模式可提高家庭照顾者的照顾能力和照顾准备度。     

家庭抗逆力在脑卒中患者日常生活能力与主要照顾者负担间的中介效应

目的 探讨家庭抗逆力在脑卒中患者日常生活能力与主要照顾者负担间的中介作用，为开展护理干预以有效减轻脑卒中患者主要照顾者负担提供参考。方法 以便利抽样法选取286例脑卒中患者及其主要照顾者，采用一般资料调查表、改良Barthel指数量表中文版、家庭抗逆力评定量表中文简化版、Zarit照顾者负担量表进行调查。结果 脑卒中患者日常生活能力总分为(40.86±13.14)分，家庭抗逆力总分为(101.85±14.78)分，照顾者负担总分为(40.98±13.68)分。脑卒中患者日常生活能力总分与家庭抗逆力总分呈正相关，二者与主要照顾者负担总分呈负相关(均P<0.05);家庭抗逆力在脑卒中患者日常生活能力与主要照顾者负担间起部分中介效应，效应量占比为37.44%。结论 脑卒中患者日常生活能力可通过家庭抗逆力的中介作用对主要照顾者负担产生影响。医护人员在促进脑卒中患者日常生活能力恢复的同时应以家庭抗逆力作为干预靶点，充分挖掘家庭内部整体力量，促进家庭抗逆力水平的提高，进而减轻脑卒中患者主要照顾者负担。     

胆道闭锁患儿住院期间父母照护体验的质性研究

目的 基于慢性病轨迹模式,探讨胆道闭锁患儿住院期间父母的照护体验,为制定针对性的护理支持方案提供参考。 方法 采用现象学研究方法,对19名胆道闭锁住院患儿父母进行半结构式访谈,采用Colaizzi 7步分析法分析访谈资料。 结果 胆道闭锁患儿住院期间不同阶段父母的照护体验可归纳为3 个主题 ,即诊断阶段：疾病认知与自我概念缺乏,情绪反应强烈;术后阶段：支持需求突出,照护负担沉重;出院阶段：希望与压力并存。 结论 胆道闭锁患儿父母在其住院期间不同阶段有着不断变化的复杂照护体验,医护人员应给予针对性的照护支持与指导,以提高患儿健康水平及减轻父母的照护负担。     

Motivating Adult Children to Provide Support to a Family Caregiver

This study compared altruistically and egoistically framed messages for encouraging adult children to support a parent providing care for an elderly relative. Undergraduate students imagined their mother filling a caregiving role while reading a message about family caregiving and the physical and psychological stresses it involves. The message encouraged participants to support the caregiver either for altruistic (other‐oriented) or egoistic (self‐oriented) reasons. Thereafter, participants completed self‐assessment surveys of attachment style and willingness to provide support. Securely attached (less self‐oriented) participants were not differentially influenced by the two messages. However, insecurely attached (more self‐oriented) participants were more willing to help if they received the egoistic message than if they received the altruistic message. Thus, knowledge of a family member's attachment style can be useful for selecting an appropriate method for encouraging caregiver support. Whereas the type of message used does not matter for securely attached individuals, an egoistically framed message may be more influential than an altruistically framed message among insecurely attached individuals. It is important that clinicians work with families to establish appropriate levels of individual commitment to caregiving responsibilities or supportive behaviours such that involvement is beneficial to the health of the caregiver, the care recipient and supporters. Copyright © 2013 John Wiley & Sons, Ltd.     

Chronic parenting stress and mood reactivity: The role of sleep quality

Sleep is a basic biological process supporting emotion regulation. The emotion regulation function of sleep may be particularly important in the context of chronic stress. To better understand how chronic stress and sleep interact to predict mood, 66 parents of children with autism completed daily diaries assessing parenting stress, negative mood, and sleep quality for 6 consecutive days. Hierarchical linear modelling revealed that daily negative mood was predicted by between‐person differences in parenting stress and between‐person differences in sleep efficiency. Further, between‐person differences in sleep efficiency and within‐person differences in sleep satisfaction moderated the impact of stress on mood. These data suggest that sleep disturbances may exacerbate the association between stress and mood in the context of chronic parenting stress. Further, high parenting stress appears to heighten the impact of transient sleep disturbances on mood.     

配偶照护负担与乳腺癌患者生活质量相关性研究

目的了解配偶照护负担与乳腺癌患者生活质量的相关性,为构建优质社会支持系统提供依据。方法采用癌症患者生活质量核心问卷(QLQ-C30)和Zarit负担量表对330例乳腺癌患者及其配偶进行调查。结果患者生活质量评分(32.45±4.09)～(69.77±10.86)分;配偶照护负担(37.08±6.95)分。配偶照护个人负担、责任负担、总体负担与患者的情感功能、整体健康呈负相关(均P0.01)。结论乳腺癌患者生活质量较差,配偶照护负担较重,二者存在负相关关系,护理人员应关注患者配偶的照护负担,给予必要的社会支持,以提高患者的生活质量。     

社区失智老人照顾者积极感受及影响因素分析

目的了解社区失智老人照顾者积极感受现况并探究其影响因素,为制定有效的社区护理干预方案提供指导。方法应用照顾者积极感受量表对80名社区失智老人照顾者进行测评。结果80名社区失智老人照顾者积极感受得分(28.53±5.37)分,得分率63.40%;回归分析结果显示,失智老人患病严重程度及是否患有其他慢性疾病是影响照顾者积极感受的主要因素(均P0.01)。结论社区失智老人照顾者积极感受水平中等,生活展望态度不佳。建议完善失智症患者的社区医疗服务,减轻失智症家庭的疾病负担,同时可开展社区失智症照顾指导干预,提高社区失智老人照顾者应对失智症的信心,提升居家照顾者的积极感受。     

Psychological characteristics and physiological reactivity to acute stress in mothers of children with autism spectrum disorder

Stress related to parenting a child with autism spectrum disorder can differently affect caregiver's physiological reactivity to acute stress. Here, parental stress levels, psychological characteristics, and coping strategies were assessed alongside measures of heart rate, heart rate variability, and cortisol during a psychosocial stress test in mothers of children with ASD (M‐ASD, n = 15) and mothers of typically developing children (n = 15). M‐ASD reported significantly higher levels of parental stress, anxiety, negative affectivity, social inhibition, and a larger preference for avoidance strategies. M‐ASD showed larger heart rate and cortisol responses to the psychosocial stress test. A positive relationship was found between parental stress levels and the magnitude of the cortisol stress response in both groups. The present findings indicate exaggerated physiological reactivity to acute psychosocial stress in M‐ASD and prompt further research to explore the role of individual differences in mediating the effects of parental stress on physiological stress responses.     

Anger and Health in Dementia Caregivers: Exploring the Mediation Effect of Optimism

Although previous studies indicate a negative association between caregivers' anger and health, the potential mechanisms linking this relationship are not yet fully understood. The aim of this study was to explore the potential mediating role of optimism in the relationship between anger and caregivers' physical health. Dementia caregivers (n = 108) were interviewed and filled out instruments assessing their anger (reaction), optimism and health (vitality). A mediational model was tested to determine whether optimism partially mediated the relationship between anger and vitality. Angry reaction was negatively associated with optimism and vitality; optimism was positively associated with vitality. Finally, the relationship between angry reaction and vitality decreased when optimism was entered simultaneously. A non‐parametric bootstrap approach confirmed that optimism significantly mediated some of the relationship between angry reaction and vitality. These findings suggest that low optimism may help explain the association between caregivers' anger and reduced sense of vitality. The results provide a specific target for intervention with caregivers. Copyright © 2013 John Wiley & Sons, Ltd.     

脑卒中偏瘫患者照顾者睡眠质量、照顾负担与心理弹性的关系

目的评估脑卒中偏瘫患者照顾者睡眠质量、照顾负担与心理弹性状况,探索脑卒中偏瘫患者照顾者心理弹性在照顾负担和睡眠质量间的中介和调节作用。方法采用匹兹堡睡眠质量指数、照顾负担量表、Connor-Davidson心理弹性量表对306名脑卒中偏瘫患者照顾者进行测评。结果照顾者睡眠质量总分为9.3±3.7,睡眠障碍检出率为57.8%;照顾负担总分为35.9±11.2,心理弹性总分为55.0±16.1。照顾负担得分与心理弹性得分呈负相关,与睡眠质量得分呈正相关;心理弹性得分与睡眠质量得分呈负相关(均P0.01)。心理弹性在照顾负担和睡眠质量间起到部分中介和调节作用。结论增强脑卒中偏瘫患者主要照顾者的心理弹性水平,有利于减轻其照顾负担,改善其睡眠质量。     

Cortisol outcomes among caucasian and latina/hispanic women caring for a family member with dementia: a preliminary examination of psychosocial predictors and effects of a psychoeducational intervention

A host of interventions are now known to be helpful to alleviate subjective distress and improve well‐being in dementia caregivers. However, few intervention studies have focused on measures of physical health, and none have examined cortisol as an outcome—despite the fact that cortisol is regarded as a crucial biological intermediary by which chronic stress leads to disease. In this study, we examined demographic and psychosocial factors as predictors of salivary cortisol at a baseline assessment, among a sample of 175 Latino/Hispanic and Caucasian women caring for a family member with dementia. We also examined the influence of a cognitive–behaviour‐based psychoeducational intervention (Coping with Caregiving) on cortisol at a post‐treatment assessment, compared with a minimal support condition. Results revealed that caregivers with high intensity caregiving situations, characterized by long hours of care and co‐residence with the care recipient, tended to have less adaptive cortisol patterns. However, these ‘at‐risk’ caregivers benefited most from the Coping with Caregiving intervention and had more normal cortisol patterns at post‐treatment, compared with caregivers in the control condition. Copyright © 2011 John Wiley & Sons, Ltd.